Correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) measures with unplanned healthcare resources utilization (HRU) among patients with epilepsy (PWE): a retrospective cohort study
Alexandra Urban1, Laura Kirkpatrick2, Vijayalakshmi Rajasekaran1, Joanna Fong1, Janel hanmer3, Anto Bagic1, Parthasarathy Thirumala1
1UPMC/University of Pittsburgh, 2UPMC/ Children's Hospital of Pittsburgh, 3University of Pittsburgh
Objective:

To evaluate whether PROMIS scores correlate with unplanned HRU among PWE.

Background:

Mental, physical, and social health determinants have a significant effect on quality of life with sparse data on their effect on unplanned HRU.

Design/Methods:

We utilized the PROMIS-16 questionnaire to assess patients’ mental, physical, and social health. Patients completed the questionnaire as part of routine medical care at outpatient neurology clinic visits. We performed a retrospective analysis of the PROMIS measures completed between June 2018, and August 2022. PROMIS data was combined with Health Plan claims data on utilization at 7, 30 and 90-day from the index clinic visit and analyzed using a logit model. A pathologic score in each of the 8 PROMIS measures (Anxiety>62, Depression>60, Fatigue >65, Pain>65, Sleep Disturbance>65, Cognition<35, Physical function<35, Social scores<35) was analyzed as an independent predictor of unplanned HRU in each of 4 domains (Mortality all causes, Hospitalization all causes, ED treat and release all causes and Urgent care all causes).

Results:

The cohort included 6485 unique PWE (13159 encounters; 53.1% females, 10.1% black, median age 46.4-years). The following statistically significant correlations emerged: 1) pathological Physical Function and Social Scores were associated with 90-day mortality; 2) pathological Fatigue, Pain, Sleep Disturbance, Physical Function, and Social Scores were associated with 7-day Hospitalization, 3) Pathological Anxiety, Depression, Fatigue, Pain, Physical Function, and Social Scores were associated with 7-day ED visits, 4) Pathological scores on each of the 8 measures correlated with 90-day Hospitalization (7 measures with a 30-day) and ED visits (5 measures with a 30-day), and 5) Pathological Fatigue scores correlated with 90-day urgent care utilization. 

Conclusions:

PROMIS scores are associated with unplanned HRU at short index times from outpatient neurology clinic visits among PWE. This prognostic utility supports the routine collection of patient‐reported health measures in clinical practice along with developing timely interventions.

10.1212/WNL.0000000000202016